Case Number 11

A 44 year old white female was first seen on 1/7/86 because the patient noticed a slight nipple retraction for 2 months. Physical exam findings were suggestive of bilateral cystic mastitis with the upper outer quadrant of the left breast and the subareolar area of the right breast being affected.

Nipple retraction could not be appreciated, although the left nipple seemed flatter than the right. The patient had a medium sized indefinite mass, subareolar at 4 o'clock, and a small pea sized mass, also subareolar, at 2 o'clock, both in the right breast. Mammogram done 1/7/86 was read as "bilateral fibrocystic changes". This was first noted by mammogram in June 1985. The patient was advised to discontinue her hormone replacement therapy, which she did. The patient was seen again on 1/30/86. On exam, the larger 4 o'clock mass in the right breast felt somewhat fatty and ill-defined but cystic feeling. The patient requested a biopsy. An excision and biopsy was done and the 2 o'clock lesion in the right breast was a 1x 1.2 cm fibroadenoma. The larger mass in the 4 o'clock area of the right breast was also removed. It weighed 25 grams and appeared fatty and fibrous. However, in the center of the mass was a 1 cm duct cell carcinoma. The patient had one lymph node positive for metastasis.

The receptor values were: Estrogen- 85 Femoles, Progesterone-560 Femoles.